MEDICARE: DR. DOUGLAS A GIROD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	04-25104	KS

General Provider Information

NPI Number	:	1194769943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS A GIROD MD

Provider Business Mailing Address
First Line	:	PO BOX 411851
Second Line	:	KANSAS UNIVERSITY PHYSICIANS INC
City	:	KANSAS CITY
State	:	MO
Zip	:	64141-1851
Country	:	US
Telephone Number	:	913-588-6701
Fax Number	:	913-588-6708

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	MS 3010
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	913-588-6701
Fax Number	:	913-588-6708

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	04/29/2015

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